How does level of personality functioning inform clinical management and treatment? Implications for ICD-11 classification of personality disorder severity.

Abstract:

PURPOSE OF REVIEW:The International Classification of Diseases, 11th Edition (ICD-11) classifies personality disturbance according to levels of severity. This article reviews the literature on levels of personality functioning in relation to clinical management and treatment, and proposes how these findings apply to the ICD-11 classification of personality disorders. RECENT FINDINGS:Findings were primarily derived from studies using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Level of Personality Functioning Scale (LPFS), Kernberg's Level of Personality Organization, and the general P-factor of personality disorder. Severity of personality dysfunction is related to treatment outcome, risk of dropout, therapeutic alliance, readiness for treatment, risk of harm to self or others, risk of dissociation and psychotic-like breaks, coherence in narrative identity, reflective functioning, and epistemic trust. SUMMARY:The overall level of personality disorder severity indicates risk of negative outcomes and may be used as decision tool for 'personalized medicine' and required treatment intensity (e.g., strength of alliance and the need for establishing epistemic trust). Beyond the ICD-11 guidelines for determining personality disorder severity, these implications also apply to practitioners using comparable frameworks such as the DSM-5 LPFS and Kernberg's Level of Personality Organization. Future research should focus on the interaction of severity with trait qualifiers in relation to clinical management.

journal_name

Curr Opin Psychiatry

authors

Bach B,Simonsen S

doi

10.1097/YCO.0000000000000658

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

54-63

issue

1

eissn

0951-7367

issn

1473-6578

pii

00001504-202101000-00010

journal_volume

34

pub_type

杂志文章
  • Recent advances in diagnosis and management of irritable bowel syndrome.

    abstract:PURPOSE OF REVIEW:This review summarizes recent progress in the diagnosis and management of irritable bowel syndrome, with a focus on dietary and microbiota aspects. RECENT FINDINGS:From a pathophysiological point of view, IBS is a multifactorial condition with both peripheral (transit) as central (visceral hypersensi...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章

    doi:10.1097/YCO.0000000000000628

    authors: Van den Houte K,Colomier E,Schol J,Carbone F,Tack J

    更新日期:2020-09-01 00:00:00

  • Diagnosis and treatment of patients with comorbid substance use disorder and adult attention-deficit and hyperactivity disorder: a review of recent publications.

    abstract:PURPOSE OF REVIEW:Attention-deficit and hyperactivity disorder (ADHD) often presents with comorbid substance use disorders (SUD). Due to similarities in key symptoms of both disorders and suboptimal efficacy of the available treatments, clinicians are faced with difficulties in the diagnosis and treatment of these pati...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000513

    authors: van der Burg D,Crunelle CL,Matthys F,van den Brink W

    更新日期:2019-07-01 00:00:00

  • Circadian rhythms and sleep in bipolar disorder: implications for pathophysiology and treatment.

    abstract:PURPOSE OF REVIEW:Multiple lines of evidence support the conceptualization of bipolar disorder as a disorder of circadian rhythms. Considering bipolar disorder in the framework of circadian disturbances also helps understand the clinical phenomenology pointing toward a multisystemic involvement. RECENT FINDINGS:Patien...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000108

    authors: Soreca I

    更新日期:2014-11-01 00:00:00

  • Service provision for mentally disordered homeless people.

    abstract:PURPOSE OF REVIEW:Mentally ill homeless persons are among the most neglected or marginalized patient groups. Their needs for mental healthcare are widely unmet. The current economic crisis probably accelerates the social decline and deterioration of physical and mental health in high-risk groups worldwide and increases...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e328361e596

    authors: Salize HJ,Werner A,Jacke CO

    更新日期:2013-07-01 00:00:00

  • Prevention of common mental disorders: conceptual framework and effective interventions.

    abstract:PURPOSE OF REVIEW:Mental disorders take a major toll, economically, socially, and psychologically, on individuals, families, and societies. Prevention provides an important and realistic opportunity to overcome this major health problem. This review outlines a conceptual framework for mental health prevention and effec...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000076

    authors: D'Arcy C,Meng X

    更新日期:2014-07-01 00:00:00

  • Conceptual issues in psychiatric neuroimaging.

    abstract:PURPOSE OF REVIEW:Psychiatric neuroimaging has made a dramatic impact on the understanding of the brain in mental illness in a relatively brief period of time and continues to be evolving in terms of methodology, analysis and utilization of the combination of techniques. Given the level of sophistication of the techniq...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/01.yco.0000245750.98749.1b

    authors: Fusar-Poli P,Broome MR

    更新日期:2006-11-01 00:00:00

  • Comorbidity of psychiatric and substance use disorders in the United States: current issues and findings from the NESARC.

    abstract:PURPOSE OF REVIEW:The comorbidity between psychiatric and substance use disorders remains an important phenomenon to understand, and an active area of investigation. The purpose of this review is to highlight key 2011 issues and novel findings on psychiatric and substance disorders comorbidity from the National Epidemi...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e3283523dcc

    authors: Hasin D,Kilcoyne B

    更新日期:2012-05-01 00:00:00

  • Schizophrenia and violence: a search for neurobiological correlates.

    abstract:PURPOSE OF REVIEW:Compelling evidence suggests that a small group of men who develop schizophrenia display a stable pattern of antisocial behaviour from childhood onwards, causing considerable suffering to victims and to themselves and imposing a significant financial burden on society. We reviewed the literature on th...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/01.yco.0000238484.12023.aa

    authors: Naudts K,Hodgins S

    更新日期:2006-09-01 00:00:00

  • Improving transitions for young people who move from child and adolescent mental health services to mental health services for adults: lessons from research and young people's and practitioners' experiences.

    abstract:PURPOSE OF REVIEW:The importance of ensuring robust arrangements for young people's transitions from specialist child and adolescent mental health services to specialist mental health services for adults is well documented in the international literature. Nonetheless, according to young people, there remains great vari...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e32833a51e2

    authors: Muñoz-Solomando A,Townley M,Williams R

    更新日期:2010-07-01 00:00:00

  • Treatment-refractory schizophrenia.

    abstract:PURPOSE OF REVIEW:The aim of this article is to critically review the current literature on treatment-refractory schizophrenia with an emphasis on emergent themes and key findings. RECENT FINDINGS:New information continues to emerge on the impact of each second-generation antipsychotic on the treatment-refractory pati...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章

    doi:10.1097/00001504-200503000-00010

    authors: Buckley PF,Shendarkar N

    更新日期:2005-03-01 00:00:00

  • Smoking in schizophrenia: recent findings about an old problem.

    abstract:PURPOSE OF REVIEW:Recent epidemiology, biological and clinical findings correlate high cigarette consumption in patients with schizophrenia, impeding both treatment strategies and the effectiveness of antipsychotics. RECENT FINDINGS:New data suggests that despite world-wide efforts to curb cigarette consumption, smoki...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000529

    authors: Sagud M,Mihaljevic Peles A,Pivac N

    更新日期:2019-09-01 00:00:00

  • Posttraumatic stress disorder and terrorism: 5 years after 9/11.

    abstract:PURPOSE OF REVIEW:This article aims to review and summarize the recent literature investigating the relationship between posttraumatic stress disorder and terrorism. A particular focus is given to the studies related to the terrorist attacks on New York City and Washington, DC on 11 September 2001. The review aims to p...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e328010dc2c

    authors: Laugharne J,Janca A,Widiger T

    更新日期:2007-01-01 00:00:00

  • Conceptual and ethical issues with brain-hardware interfaces.

    abstract:PURPOSE OF REVIEW:Progress in neurosciences, increasing computational power, and ongoing miniaturization of micro-technological components enable both a better understanding of human brain functions and development of new diagnostic and therapeutic tools. Research and development as well as clinical application of devi...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e32834bb8ca

    authors: Clausen J

    更新日期:2011-11-01 00:00:00

  • Alcohol-related problems in adolescents and adults with intellectual disabilities.

    abstract:PURPOSE OF REVIEW:Alcohol is widely available and one of the most commonly used psychoactive substances. This review examined the recent literature for empirical research addressing the cause, prevalence and treatment of alcohol-related problems in adolescents and adults with intellectual disabilities. RECENT FINDINGS...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/01.yco.0000238474.07078.41

    authors: Barrett N,Paschos D

    更新日期:2006-09-01 00:00:00

  • Role of behavioral medicine in primary care.

    abstract:PURPOSE OF REVIEW:Behavioral medicine is a vast field with an ever-increasing knowledge base. We review important findings over the last 18 months. RECENT FINDINGS:We organized advances in behavioral medicine into four main topic areas: the doctor and patient, health-related behavior, integration of behavioral medicin...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e3283503576

    authors: Feldman MD,Berkowitz SA

    更新日期:2012-03-01 00:00:00

  • The importance of faith-based mental healthcare in African urbanized sites.

    abstract:PURPOSE OF REVIEW:This review highlights what current research says about how local beliefs and norms can facilitate expansion of mental healthcare to meet the large unmet need for services in Africa. RECENT FINDINGS:In contemporary Africa, religious beliefs exert important influences on mental health as well as the w...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章

    doi:10.1097/YCO.0000000000000590

    authors: Ojagbemi A,Gureje O

    更新日期:2020-05-01 00:00:00

  • Foetal alcohol spectrum disorder: identifying the neurobehavioural phenotype and effective interventions.

    abstract:PURPOSE OF REVIEW:Since the first description of the foetal damage of alcohol in 1967, numerous studies have outlined different aspects of neurodevelopmental dysfunction, adversely affecting the lives of children worldwide. Although the cause of the syndrome is sorted out, the pathogenesis of brain damage is far from b...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000038

    authors: Koren G,Zelner I,Nash K,Koren G

    更新日期:2014-03-01 00:00:00

  • Ethical and conceptual issues in eating disorders.

    abstract:PURPOSE OF REVIEW:This review considers the literature on ethical and conceptual issues in eating disorders from the last 18 months. Some reference to earlier work is necessary in order to provide context for the recent findings from research that is ongoing. RECENT FINDINGS:Empirical ethics research on anorexia nervo...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e328365a3a1

    authors: Charland LC

    更新日期:2013-11-01 00:00:00

  • Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States.

    abstract:PURPOSE OF REVIEW:We reviewed the recent literature on prevalence rates, and application of evidence-based treatments for eating disorders among Hispanics/Latinos residing in the United States. RECENT FINDINGS:Lifetime prevalence rates of anorexia nervosa are lower among Hispanic/Latinos than non-Hispanic Whites. Ther...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000277

    authors: Perez M,Ohrt TK,Hoek HW

    更新日期:2016-11-01 00:00:00

  • The epidemiology and characteristics of stalking.

    abstract:PURPOSE OF REVIEW:This article summarizes major results in the field of epidemiology and characteristics of stalking, as published in literature between 2003 and October 2005. RECENT FINDINGS:Although stalking had been only recently conceptualized, it soon became evident that it represents a significant social and med...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/01.yco.0000228760.95237.f5

    authors: Dressing H,Kuehner C,Gass P

    更新日期:2006-07-01 00:00:00

  • The impact of urbanization on mental health in India.

    abstract:PURPOSE OF REVIEW:India has experienced rapid urbanization in the last few decades. This review focuses on recent research related to the effects of urbanization on mental health with a specific focus on various population groups in urban India. RECENT FINDINGS:With a specific focus on recent research undertaken among...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000408

    authors: Chandra PS,Shiva L,Nanjundaswamy MH

    更新日期:2018-05-01 00:00:00

  • Ecstasy and other club drugs: a review of recent epidemiologic studies.

    abstract:PURPOSE OF REVIEW:This review highlights the epidemiologic research on club drug use in the past year, with a focus on clinical epidemiology, social epidemiology, new methodological approaches, and alternative explanations for drug use behaviors. RECENT FINDINGS:Although 3,4-methylenedioxy-N-methylamphetamine (MDMA) o...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,多中心研究,评审

    doi:10.1097/YCO.0b013e3282f9b1f1

    authors: Leung KS,Cottler LB

    更新日期:2008-05-01 00:00:00

  • Smell identification function and Alzheimer's disease: a selective review.

    abstract:PURPOSE OF REVIEW:To provide an update of the recent studies on the olfactory function in Alzheimer's disease, with a focus on the olfactory identification function. RECENT FINDINGS:The studies reviewed here confirm previous reports on the poor olfactory function in Alzheimer's disease compared to health normal contro...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000146

    authors: Velayudhan L

    更新日期:2015-03-01 00:00:00

  • Magnitude and impact of comorbidity of mental disorders from epidemiologic surveys.

    abstract:PURPOSE OF REVIEW:To consider comorbidity across multiple classes of disorders in data derived from recent large-scale community surveys. RECENT FINDINGS:There has been substantial recent progress in our understanding of patterns and implications of comorbidity of mental disorders. There is now converging evidence on ...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e3281c61dc5

    authors: Merikangas KR,Kalaydjian A

    更新日期:2007-07-01 00:00:00

  • Pharmacotherapy and other treatments for cocaine abuse and dependence.

    abstract:PURPOSE OF REVIEW:This review examines progress being made in the treatment of cocaine abuse and dependence, with a particular focus on pharmacotherapies. Medications with apparently very different mechanisms of action have been reported to reduce cocaine use in controlled clinical trials in outpatient settings. This r...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章

    doi:10.1097/01.yco.0000165596.98552.02

    authors: Vocci FJ,Elkashef A

    更新日期:2005-05-01 00:00:00

  • Ethical issues in obtaining collateral information on alcohol and drug use: experience from Asia and Africa.

    abstract:PURPOSE OF REVIEW:In many regions of the world, wives of alcohol and drug-using men are at an increased risk for HIV/AIDS because of their husbands' high-risk behaviours. These women also tend to be poor, illiterate and dependent on their husbands. Few interventions are designed exclusively for these women. Furthermore...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e328361ebd7

    authors: Varma DS,Chandra PS,O'Leary CC,Reich W,Cottler LB

    更新日期:2013-07-01 00:00:00

  • Approaches to decrease the prevalence of depression in later life.

    abstract:PURPOSE OF REVIEW:Depression is a common and disabling disorder that affects people of all ages and 10% of those older than 65 years. Current strategies to decrease the personal and societal burden of depression in older age rely on the management of people with depression or of those at risk, but benefits have been li...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e328356bd57

    authors: Almeida OP

    更新日期:2012-11-01 00:00:00

  • Acurate diagnosis of delirium in elderly patients.

    abstract:PURPOSE OF REVIEW:Delirium remains one of the most common complicating diagnoses in ailing elderly patients and a leading cause of morbidity, decreased quality of life, prolonged hospital stay, institutionalization and mortality. Despite its clinical importance and health-related costs, it often remains unrecognized or...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0b013e3280ec52e5

    authors: Moraga AV,Rodriguez-Pascual C

    更新日期:2007-05-01 00:00:00

  • Provision of arts therapies for people with severe mental illness.

    abstract:PURPOSE OF REVIEW:Arts therapies are still inadequately regulated throughout the world despite a 100-year-long tradition, a vast number of academically trained therapists and importance in treating psychiatric patients. It is essential that more evidence-based studies are undertaken. RECENT FINDINGS:Current internatio...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章,评审

    doi:10.1097/YCO.0000000000000338

    authors: Fenner P,Abdelazim RS,Bräuninger I,Strehlow G,Seifert K

    更新日期:2017-07-01 00:00:00

  • Postgraduate training in psychiatry in Asia.

    abstract:PURPOSE OF REVIEW:To understand the current situation, needs and challenges in the area of postgraduate training in psychiatry in Asia and identify implementable solutions.Leaders in psychiatric education from nine Asia Pacific countries prepared country reports, based on a suggested list of items and met for a day to ...

    journal_title:Current opinion in psychiatry

    pub_type: 杂志文章

    doi:10.1097/YCO.0000000000000444

    authors: Isaac M,Ahmed HU,Chaturvedi SK,Hopwood MJ,Javeed A,Kanba S,Mufti AA,Maramis A,Samaniego RM,Udomratn P,Yanling H,Zainal NZ,Sartorius N

    更新日期:2018-09-01 00:00:00